Risk factors for and outcomes of noncatastrophic suspensory apparatus injury in Thoroughbred racehorses

OBJECTIVE: To evaluate effects of toe grabs, exercise intensity, and distance traveled as risk factors for subclinical to mild suspensory apparatus injury (SMSAI) in Thoroughbred racehorses and to compare incidence of severe musculoskeletal injury (MSI) in horses with and without SMSAI. DESIGN: Nested case-control study. ANIMALS: 219 Thoroughbred racehorses racing or in race training. PROCEDURE: Racehorses were examined weekly for 90 days to determine incidence of suspensory ligament injury and monitor horseshoe characteristics. Every horse's exercise speeds and distances were recorded daily. Conditional logistic regression was used to compare exposure variables between incident case (n = 25) and selected control (125) horses. Survival analysis was used to compare time to MSI for horses with (n = 41) and without (76) SMSAI. RESULTS: The best-fitting logistic model for the data included age (< 5 vs > or = 5 years old), toe grab height the week of injury (none vs very low, low, regular, or Quarter Horse height), and weekly distance the week preceding injury (miles). Although the 95% confidence intervals for all odds ratios included 1, the odds for SMSAI appeared to increase with the presence of a toe grab, higher weekly distance, and age > or = 5 years. Horses that had SMSAI were significantly more likely to have a severe MSI or severe suspensory apparatus injury than were horses that did not. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that pre-existing SMSAI is associated with development of severe MSI and severe suspensory apparatus injury. Modifying training intensity and toe grab height for horses with SMSAI may decrease the incidence of severe MSI.     

Effects of injury to the suspensory apparatus, exercise, and horseshoe characteristics on the risk of lateral condylar fracture and suspensory apparatus failure in forelimbs of thoroughbred racehorses

OBJECTIVE: To assess concurrently the effects of moderate ligamentous suspensory apparatus injury (MLSAI), racing-speed exercise, and horseshoe characteristics on risk of catastrophic suspensory apparatus failure (SAF) or metacarpal condylar fracture (CDY) in forelimbs of racehorses. SAMPLE POPULATION: Cadavers of 301 Thoroughbred racehorses (108 with SAF, 33 with CDY and 160 control horses). PROCEDURE: A cross-sectional epidemiologic study was used to describe distributions and relationships between MLSAI, exercise, and horseshoe variables. Logistic regression was used to assess potential risk factors for developing SAF and CDY. RESULTS: Exercise variables were more highly associated with age than height of a steel bar affixed to the ground surface of the front of a horseshoe (ie, toe grab) or sex. Marginal associations were detected between MLSAI and age and height of toe grab. Higher risk for developing SAF was associated with MLSAI, use of a pad on a horseshoe, longer interval since last period of > or = 60 days without a race or timed workout (ie, layup), 2 to 5 career races, and higher intensity of recent exercise. Higher risk for developing CDY was associated with MLSAI, male horses, age between 2 and 5 years, higher intensity of recent exercise, and longer interval since layup. CONCLUSIONS AND CLINICAL RELEVANCE: Recognition of MLSAI and rehabilitation of affected horses should reduce incidence of SAF and CDY. Horses in longterm continuous training with recent high-intensity exercise are at greater risk for injury. Use of pads in horseshoes was associated with SAF, although the relationship may not be causal.     

Race-start characteristics and risk of catastrophic musculoskeletal injury in Thoroughbred racehorses

OBJECTIVE: To identify race-start characteristics associated with catastrophic musculoskeletal (MS) injury in Thoroughbred racehorses at 2 racetracks in Florida during 1995 through 1998. DESIGN: Matched case-control study. ANIMALS: 97 Thoroughbreds (case horses) that incurred a catastrophic MS injury during racing and 388 Thoroughbreds (control horses) randomly selected from noninjured participants and matched on the basis of racetrack and year. PROCEDURE: Incidence of MS injury was calculated for all race meets at 2 racetracks in Florida from 1995 through 1998. Race-start characteristics were compared among case and control horses, using conditional logistic regression. RESULTS: Overall incidence of MS injury was 1.2/1,000 race starts (97/79,416 starts). Incidence of injury was significantly higher for turf races (2.3/1,000 starts) than for dirt races (0.9/1,000 starts). Sex, number of days since last race, and racing surface were associated with risk of injury; geldings, > or = 33 days since the last race, and turf racing surface were associated with a higher risk of injury. CONCLUSIONS AND CLINICAL RELEVANCE: Incidence of injury among Thoroughbreds in Florida was associated with sex, number of days since last race, and racing surface. Days since last race may have been an indicator of previous health and lameness problems. Racing surface may have been a risk factor for MS injury because turf races tended to be more competitive than dirt races. Horses running in turf races were more likely to participate in races with a large field, handicap races, long races, and races with high purses.     

Risk factors for Thoroughbred racehorse fatality in flat starts in Victoria, Australia (1989-2004)

REASONS FOR PERFORMING STUDY: Research into risk factors specific for fatality in flat racing should be focused at a regional level as the risk factors may differ among countries and even regions within countries. OBJECTIVE: To identify risk factors for fatality of Thoroughbred racehorses in flat starts on all racecourses in Victoria, Australia between 1989 and 2004. METHODS: Fatalities comprised all horses that died during or immediately after a flat race or official flat trial, and all horses that were subjected to euthanasia within 24 h of an event in which an injury was sustained. The retrospective study involved 283 case starts and 3307 control starts. Univariable and multivariable backward stepwise logistic regression was used to identify risk factors for fatality at any one start. RESULTS: In the final multivariable model, horse gender, prior racing history, race length, racing year, racecourse location and track rating were associated with fatality. CONCLUSIONS: This study identified specific risk factors for fatality. The findings are consistent with the hypothesis that horses accumulating high speed exercise are predisposed to catastrophic injury. The study has also highlighted the need to investigate further the adverse effects of different track ratings on the incidence of injury and subsequent fatality. RELEVANCE: The results will facilitate the development of effective strategies to improve overall safety of horses and jockeys in flat racing in Victoria, Australia.     

Characteristics of Thoroughbred and Quarter Horse racehorses that sustained a complete scapular fracture

Reasons for performing study: To determine if scapular fractures occur in racehorses with distinctive characteristics. Objectives: To test the hypothesis that Thoroughbred (TB) and Quarter Horse (QH) racehorses with a scapular fracture have similar characteristics that are different from those of their respective racetrack populations. Methods: Necropsy findings, case details, last race information and career earnings for TB and QH racehorses that had a scapular fracture in California between 1990 and 2008 were retrospectively compared between breeds. Horse signalment, career earnings, career starts and race characteristics were obtained for all California racehorses. Comparisons were made between affected horses, other racehorses that died, and all horses that raced, in California during the 19 year period. Results: Seventy‐three TB and 28 QH racehorses had a similar, complete comminuted scapular fracture with an articular component, and right forelimb predilection. The QHs had a higher incidence of scapular fracture incurred during racing than TBs (0.98 vs. 0.39/1000 starters). The TB and QH incident rates for musculoskeletal deaths incurred racing were 20.5 and 17.5/1000 starters, respectively; however, a greater proportion of TB musculoskeletal deaths occurred training (40% vs. 8%). Horses with a scapular fracture were more likely to be male and aged 2 or ≥5 years than the racetrack population. Most affected QHs (64%) were 2‐year‐olds; most TBs (74%) were aged ≥3 years. Scapular fractures occurred more commonly during racing in QHs (70%) than TBs (44%). Race‐related scapular fracture was more likely to occur in a Maiden race than in a non‐Maiden race. Horses with a scapular fracture had fewer career starts than the racetrack population. Conclusions and potential relevance: Despite breed differences for signalment and exercise distances, both breeds incur a complete scapular fracture that is more likely to occur in the right scapula of young and older, male racehorses, early in their race career or after few races. Quarter Horses sustain a catastrophic scapular fracture more frequently than TBs.     

Risk factors for race-associated sudden death in Thoroughbred racehorses in the UK (2000-2007)

Reasons for performing study: Sudden death adversely affects racehorse welfare, jockey safety and the public perception of horseracing. Objective: To describe the risk of racing‐associated sudden death in Thoroughbred racehorses in the UK from 2000 to 2007, to identify whether there were risk factors uniquely associated with sudden death and to improve the understanding of the pathogenesis of racing‐associated sudden death by identification of risk factors for such cases. Methods: A sudden death was defined as an acute collapse and death, in an apparently healthy Thoroughbred racehorse, during or immediately after racing, in the absence of clinical data indicative of a catastrophic orthopaedic injury. The retrospective study included 201 case race starts and 705,712 control race starts. Univariable and multivariable logistic regression were used to identify risk factors for sudden death at any one start. Results: In the multivariable model, age, distance, race type, season and number of starts in the 60 days prior to the race were associated with sudden death. Conclusions: The risk factors identified in this study are not uniquely associated with sudden death and have been also been identified in studies using all causes of fatality as the outcome. These data suggest that a generic approach to reduce fatal musculoskeletal injury and sudden death may be possible. Potential relevance: The identification of risk factors allows speculation on the underlying mechanisms of sudden death in racing. This may stimulate hypothesis‐led investigations into the pathogenesis of exercise‐related arrhythmias, exercise‐induced pulmonary haemorrhage and blood vessel rupture. See also correspondence by Cook     

Association between race history and risk of superficial digital flexor tendon injury in Thoroughbred racehorses

OBJECTIVE: To determine whether race history, including the number of races and total race distance, was associated with risk of superficial digital flexor tendon (SDFT) injury in Thoroughbred racehorses in Japan. DESIGN: Matched case-control study. ANIMALS: 515 Thoroughbred racehorses (case horses) that sustained an SDFT injury during training or racing in Japan during 2002 and 951 horses (control horses) without SDFT injury that were matched with case horses on the basis of age and month of the latest race. PROCEDURE: Variables related to race history were compared between case and control horses by means of conditional logistic regression. RESULTS: The odds of SDFT injury increased as mean race distance and mean body weight at race time increased. Compared with females that had never competed in steeplechase races, males regardless of steeplechase race history and females that had competed in steeplechase races had higher odds of SDFT injury. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that longer mean distance per race, heavier mean body weight at race time, steeplechase experience, and sex (male) increased the risk of SDFT injury in Thoroughbred racehorses.     

Frequency of musculoskeletal injuries and risk factors associated with injuries incurred in Quarter Horses during races.

OBJECTIVE: To determine the frequency and anatomic location of musculoskeletal injuries incurred by Quarter Horses during races and to compare data from injured horses and matched control horses. DESIGN: Matched case-control study. ANIMALS: 97 Quarter Horses that sustained a musculoskeletal injury during races and 291 horses from the same races that were not injured. PROCEDURE: Data examined included racing history, race-entrant characteristics, racing events determined by analysis of videotapes of races, and, when performed, results of prerace physical inspections. Data for injured horses were compared with data for control horses, using conditional logistic regression. RESULTS: Incidence of a catastrophic injury among Quarter Horses during races was approximately 0.8/1,000 race starts, whereas incidence of musculoskeletal injury during racing was approximately 2.2/1,000 race starts. Odds of musculoskeletal injury were approximately 8 times greater among horses assessed to be at increased risk of injury on the basis of results of prerace physical inspection than for horses not considered to be at increased risk of injury. Evidence was lacking that 2-year-old horses were at increased risk of injury or that sex influenced the risk of injury among Quarter Horses during races. CONCLUSIONS AND CLINICAL RELEVANCE: Incidence of racing injury among Quarter Horses appears to be lower than that observed among Thoroughbreds. Regulatory veterinarians can identify horses at increased risk of injury on the basis of prerace physical inspection, indicating that these inspections could be used to reduce the risk of injury during races.     

Risk factors for musculoskeletal injuries of the lower limbs in Thoroughbred racehorses in New Zealand

AIM: To investigate risk factors for injury to musculoskeletal structures of the lower fore- and hind-limbs of Thoroughbred horses training and racing in New Zealand.

METHODS: A case-control study analysed by logistic regression was used to compare explanatory variables for musculoskeletal injuries (MSI) in racehorses. The first dataset, termed the Training dataset, involved 459 first-occurrence cases of lower-limb MSI in horses in training, and the second, the Starting dataset, comprised a subset of those horses that had started in at least one trial or race in the training preparation that ended with MSI (n=294). All training preparations for horses that did not suffer from MSI for which complete data were available were used in the analyses as controls, and provided 2,181 and 1,639 preparations for the Training and Starting datasets, respectively. Multivariate logistic regression was used to evaluate risk factors, and results were reported as odds ratios (OR) and 95% confidence intervals (CI).

RESULTS: Horses aged ≥5 years were at higher risk of injury than 2-year-olds. Elevated odds of MSI occurred in horses in the Starting dataset that were training in the 1997–1998 year compared with the 1999–2000 year, and in those horses where trials comprised >20% of all starts in a preparation. Training preparations that ended in winter, and horses in their third or later training preparation, had lower odds of MSI compared with those ending in other seasons or the first preparation, respectively. Reduced odds of MSI were observed in preparations in which starts occurred compared with those that had no starts, and in the Starting dataset, preparations that included more than one start had a reduced likelihood of MSI compared with preparations that had only one start. In the Training dataset, preparations longer than 20 weeks were associated with reduced odds of MSI compared with those shorter than 20 weeks.

Cumulative racing distance in the last 30 days of a training preparation was best modelled with linear and quadratic terms. Results indicated that increasing cumulative racing distances were associated with an initial reduction in the odds of MSI that then levelled out and finally appeared to increase again as the explanatory variable continued to increase. The risk of MSI varied significantly between trainers.

CONCLUSION: This study identified intrinsic (age) and extrinsic risk factors for MSI in training and racing Thoroughbreds in New Zealand. The risk of MSI initially decreased, then increased, as cumulative racing distance increased. Significant variation between trainers indicated management and training methods influence the risk of MSI.     

Risk factors for musculoskeletal injuries of the lower limbs in Thoroughbred racehorses in New Zealand

AIM: To investigate risk factors for injury to musculoskeletal structures of the lower fore- and hind-limbs of Thoroughbred horses training and racing in New Zealand. METHODS: A case-control study analysed by logistic regression was used to compare explanatory variables for musculoskeletal injuries (MSI) in racehorses. The first dataset, termed the Training dataset, involved 459 first-occurrence cases of lower-limb MSI in horses in training, and the second, the Starting dataset, comprised a subset of those horses that had started in at least one trial or race in the training preparation that ended with MSI (n=294). All training preparations for horses that did not suffer from MSI for which complete data were available were used in the analyses as controls, and provided 2,181 and 1,639 preparations for the Training and Starting datasets, respectively. Multivariate logistic regression was used to evaluate risk factors, and results were reported as odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Horses aged > or =5 years were at higher risk of injury than 2-year-olds. Elevated odds of MSI occurred in horses in the Starting dataset that were training in the 1997-1998 year compared with the 1999-2000 year, and in those horses where trials comprised >20% of all starts in a preparation. Training preparations that ended in winter, and horses in their third or later training preparation, had lower odds of MSI compared with those ending in other seasons or the first preparation, respectively. Reduced odds of MSI were observed in preparations in which starts occurred compared with those that had no starts, and in the Starting dataset, preparations that included more than one start had a reduced likelihood of MSI compared with preparations that had only one start. In the Training dataset, preparations longer than 20 weeks were associated with reduced odds of MSI compared with those shorter than 20 weeks. Cumulative racing distance in the last 30 days of a training preparation was best modelled with linear and quadratic terms. Results indicated that increasing cumulative racing distances were associated with an initial reduction in the odds of MSI that then levelled out and finally appeared to increase again as the explanatory variable continued to increase. The risk of MSI varied significantly between trainers. CONCLUSION: This study identified intrinsic (age) and extrinsic risk factors for MSI in training and racing Thoroughbreds in New Zealand. The risk of MSI initially decreased, then increased, as cumulative racing distance increased. Significant variation between trainers indicated management and training methods influence the risk of MSI.     

Risk factors for atrial fibrillation during racing in slow-finishing horses

OBJECTIVE: To determine prevalence of atrial fibrillation (AF) immediately after racing among racehorses that finished well behind the winners and examine potential risk factors for AF in these horses. DESIGN: Case-control study. ANIMALS: 39,302 racehorses representing 404,090 race starts in races sanctioned by the Japan Racing Association between 1988 and 1997. PROCEDURE: Horses that finished > or = 4 (turf races) or 5 (dirt races) seconds behind the winner or that did not complete the race were examined for AF within 5 minutes after the race. Logistic regression and chi2 analyses were used to determine whether sex, age, race distance, race surface, year, or development of epistaxis was associated with development of AF. RESULTS: Estimated minimum frequency of AF was 0.03% (123 instances of AF following 404,090 race starts), and estimated minimum prevalence of AF among racehorses was 0.29% (115 horses with AF among 39,302 racehorses). Estimated frequency of AF among horses that finished slowly or did not finish was 1.39% (120 instances of AF among 8,639 examinations), and estimated prevalence of AF in horses that finished slowly was 1.23% (92 instances of AF among 7,500 horses) or 1.01% when only the first time a horse finished slowly was considered (76 instances of AF among 7,500 horses). Atrial fibrillation was paroxysmal in most horses. Among horses that finished slowly, 4-year-old and older horses and horses that raced on turf were more likely to develop AF. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the likelihood of AF among racehorses that finish slowly is related to age and racing surface.     

The horse-racetrack interface: a preliminary study on the effect of shoeing on impact trauma using a novel wireless data acquisition system

REASONS FOR PERFORMING STUDY: There is a need to determine accelerations acting on the equine hoof under field conditions in order to better assess the risks for orthopaedic health associated with shoeing practices and/or surface conditions. OBJECTIVES: To measure the acceleration profiles generated in Thoroughbred racehorses exercising at high speeds over dirt racetracks and specifically to evaluate the effect of a toe grab shoe compared to a flat racing plate, using a newly developed wireless data acquisition system (WDAS). METHODS: Four Thoroughbred racehorses in training and racing were used. Based on previous trials, each horse served as its own control for speed trials, with shoe type as variable. Horses were evaluated at speeds ranging from 12.0-17.3 m/sec. Impact accelerations, acceleration on break over and take-off, and temporal stride parameters were calculated. Impact injury scores were also determined, using peak accelerations and the time over which they occurred. RESULTS: Recorded accelerations for the resultant vector (all horses all speeds) calculated from triaxial accelerometers ranged 96.3-251.1 g, depending on the phase of the impact event. An association was observed between shoe type and change in acceleration in individual horses, with 2 horses having increased g on initial impact with toe grab shoes in place. In the final impact phase, one horse had an increase of 110 g while wearing toe grab shoes. Increased accelerations were also observed on break over in 2 horses while wearing toe grab shoes. CONCLUSIONS: Shoe type may change impact accelerations significantly in an individual horse and could represent increased risk for injury. Further work is needed to determine if trends exist across a population. POTENTIAL RELEVANCE: The WDAS could be used for performance evaluation in individual horses to evaluate any component of the horse-performance surface interface, with the goal of minimising risk and optimising performance.     

Musculoskeletal injuries in Standardbred racehorses on Prince Edward Island

A study of musculoskeletal injuries in Standardbred racehorses on Prince Edward Island was conducted to determine the incidence and risk factors for injury. Monthly information was collected from 10 trainers and 153 Standardbred horses over a 12-month period. Seventeen new injuries were identified in pacers, representing a horse level incidence risk of 23% and an incidence rate of injury of 2.19 per horse-month at risk. Forty-one percent of the injuries occurred during a race, 53% during training and 6% during jogging. Fourteen horses had experienced a previous injury and 3 of these horses experienced a new injury during the study period. Potential risk factors for injury were the speed at which the horse was trained, previous injury, and the conformational fault of offset knees.     

Risk factors for injury to the superficial digital flexor tendon and suspensory apparatus in Thoroughbred racehorses in New Zealand

AIM: To investigate risk factors for injury to the superficial digital flexor tendon (SDFT) and suspensory apparatus (SA) of the forelimbs in Thoroughbred racehorses in New Zealand.

METHODS: Poisson and negative binomial regression, with exposure time represented by cumulative training days for each horse, were used to relate explanatory variables to the incidence rate (IR) of cases of inflammation of the SDFT (n=51), and injuries involving the SA (n=48) in a population of 1,571 commercially-trained racehorses over 554,745 study days. Only the first occurrence of an injury for any one horse was eligible for inclusion. Separate analyses were run for data from horses in training regardless of whether they had started in a trial or race, and using a subset of these data restricted to those preparations associated with at least one start in a trial or race. Results were reported as incidence rate ratios (IRR) and 95% confidence intervals (CI).

RESULTS: Male horses had a higher risk of injury to the SA (IRR 2.57; p=0.005) and tended to have a higher risk of injury to the SDFT (IRR 1.74; p=0.09) than female horses. Increasing age was associated with increased risk of injury. Horses aged 4 and ≥5 years were 6.76 (p<0.001) and 15.26 (p<0.001) times more likely to incur injury to the SDFT, and 2.91 (p=0.02) and 3.54 (p=0.005) times more likely to incur injury to the SA, respectively, than 2-year-olds. Horses were more likely to suffer an injury to the SDFT or SA in a training preparation that was not associated with any starts in official trials or races compared with those preparations that were associated with more than one start (p<0.001), and more likely to injure the SA compared with preparations containing one start (p=0.03). The IR of injury to the SDFT tended to be lower between November–January (IRR 0.78; p=0.08) and February-April (IRR 0.75; p=0.08) compared with August–October. Incidence of injury to the SDFT or SA was not associated with the cumulative distance raced in the last 30 days of a training preparation.

CONCLUSION: This study identified risk factors for injury to the SDFT and SA in Thoroughbred racehorses in New Zealand. Injuries were more likely in males, older horses and in horses in training preparations without any starts. There was no evidence of association between injury and cumulative high-speed exercise.     

Epidemiologic characteristics of catastrophic musculoskeletal injuries in Thoroughbred racehorses

OBJECTIVE: To determine characteristics, incidence rate, and possible associations with selected demographic characteristics of catastrophic musculoskeletal injuries (CMIs) in Thoroughbred racehorses. ANIMALS: 76 Thoroughbreds with CMIs. PROCEDURES: Incidence rates of CMIs during racing or training were calculated with number of CMIs as the numerator and overall numbers of races or training events during 2004 and 2005 as the denominators. Exact 95% confidence intervals were calculated. Associations between incidence and dichotomous exposure factors, nominal factors, and ordinal factors were determined. Only univariable associations were examined. RESULTS: 76 horses were euthanized because of CMI and represented 2.36 and 1.69 deaths/1,000 racing starts in 2004 and 2005, respectively. Of these, 57 were euthanized within 60 days before or after a race, which yielded a point incidence of 1.05/1,000 racing starts and 0.39/1,000 training starts. CONCLUSIONS AND CLINICAL RELEVANCE: Incidence rate of CMIs at 2 Ontario racetracks was similar to that at other North American racetracks. A cumulative death rate of 1 to 2 deaths/wk should be considered typical when designing prevention strategies and offers a baseline value for measuring improvement.     

Cumulative racing-speed exercise distance cluster as a risk factor for fatal musculoskeletal injury in Thoroughbred racehorses in California

Thoroughbred racehorses which suffered a fatal musculoskeletal injury (FMI) while racing or race training at a California racetrack during 9 months of 1991 were studied to determine the importance of intensive, high-speed exercise schedules prior to injury. Seventy-seven horses which sustained an FMI while racing and 45 horses which sustained an FMI while race training were successfully matched by race or timed workout session with one control horse and included in the analyses. Race and timed workout (racing-speed exercise) histories were obtained for the case and control horses. Two-month cumulative, racing-speed cutoff distances were calculated from the control horse sample by two methods. Median racing-speed exercise frequencies and distances of the control horses were used to estimate age-specific (2, 3, 4 and ≥ 5 years), 2-month cumulative, racing-speed distances (Method 1). For the second method, the last race or timed workout for each control horse occurring just prior to, or on the date of injury for the matched case horse was identified. Cumulative racing-speed distances 2 months prior to these exercise events were determined for each control horse and used to estimate median age-specific (2, 3, 4 and ≥ 5 years), 2-month cumulative racing-speed distances (Method 2). The cumulative cutoff distances estimated from both methods were used to classify each matched pair according to the presence or absence of a 2-month cumulative, racing-speed distance which exceeded the age-appropriate cutoff distance (exercise distance cluster) within 6 months prior to injury. Manlel-Haenszel matched-pair odds ratios and 95% confidence limits were calculated separately for the racing and race-training fatal injuries. The relative risk for racing FMI was significantly greater for those horses which ran 2-month, cumulative racing and timed workout distances in excess of the cutoff values determined with Method 1 (relative risk (RR) = 3.0, 95% confidence interval (CI) = 1.2, 7.6) and Method 2 (RR = 7.2, 95% CI = 2.6, 20.6). The relative risk for race-training FMI was significantly greater for those horses which ran 2-month, cumulative racing and timed workout distances in excess of the cutoff values determined with Method 2 (RR = 3.4, 95% CI =1.0, 13.2).     

Evaluation of detailed training data to identify risk factors for retirement because of tendon injuries in Thoroughbred racehorses

OBJECTIVE: To identify the risk factors for premature retirement because of tendon injury in a Thoroughbred racehorse population. ANIMALS: 175 Thoroughbred racehorses (cases) at the Hong Kong Jockey Club that were retired from racing because of tendon injury between 1997 and 2004 and for which the last preretirement exercise was at a fast pace were each matched with 3 control horses that were randomly selected from all uninjured horses that had galloped on the same date as that last exercise episode. PROCEDURES: Training data for all horses were examined. Conditional logistic regression analyses were performed to identify risk factors for retirement from racing attributable to tendon injury. Two multivariable conditional logistic regression models were created; each contained 8 explanatory variables. RESULTS: Compared with control horses, case horses were older at the time of import, accumulated more race distance soon after import, were more likely to have had previous official veterinary or ultrasonographic examinations, raced fewer times during their career, and were in training for a longer period and had exercised at a reduced intensity during the 180-day period preceding the last fast-paced work date. CONCLUSIONS AND CLINICAL RELEVANCE: In addition to identification of risk factors for tendon injury among racing Thoroughbreds, results have suggested that resources focused on obtaining accurate training data may be misdirected in the absence of internationally agreed criteria for incident tendon injury among racehorses. Nevertheless, changes in training intensity and findings of previous clinical examinations could be used to identify horses at risk of tendon injury-associated retirement.     

Intralesional injection of platelet-rich plasma followed by controlled exercise for treatment of midbody suspensory ligament desmitis in Standardbred racehorses

OBJECTIVE: To determine outcome of Standardbred racehorses with moderate to severe midbody suspensory ligament desmitis (MSD) treated by means of ultrasound-guided intralesional injection of a single dose of platelet-rich plasma (PRP) followed by a program of gradually increased exercise. DESIGN: Nonrandomized clinical trial. ANIMALS: 9 Standardbred racehorses. PROCEDURES: Following injection of PRP, horses were allowed a controlled, gradual return to exercise. Race records for the year prior to injury and for 3 consecutive years after horses returned to racing were reviewed. For comparison purposes, race records of 9 Standardbred racehorses with no history of MSD racing at the same time were also reviewed. RESULTS: All 9 horses with MSD returned to racing after treatment; median time to return to racing was 32 weeks. All 9 horses raced at least once during the first and second years after returning to racing, but only 5 raced during the third year. When number of starts, total earnings, and earnings per start were compared between case and comparison horses, the only significant differences were number of starts during the third year after case horses returned to racing and earnings per start during the first year after case horses returned to racing, with values being significantly lower for case horses than for comparison horses. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that horses with moderate to severe MSD treated by means of intralesional injection of a single dose of PRP followed by a program of gradually increased exercise had an excellent prognosis for returning to racing.     

Association of high-speed exercise with racing injury in thoroughbreds

OBJECTIVE: To determine the association between high-speed exercise and risk of injury while racing among Thoroughbreds in Kentucky. DESIGN: Matched case-control study. ANIMALS: 206 Thoroughbreds that sustained a musculoskeletal injury while racing and 412 Thoroughbreds that were not injured during the same races. PROCEDURE: Data regarding official timed workouts and races and the Beyer's numbers for the 3 races before the race during which injury occurred were extracted from past performance charts and compared between injured horses and control horses. RESULTS: For injured horses, cumulative distance of high-speed exercise during the 1- and 2-month periods prior to the race in which injury occurred was significantly less than that of control horses; for either period, a difference of 10 furlongs was associated with approximately 2-fold greater risk of injury. Beyer's numbers were significantly higher for injured horses than for control horses. These effects remained significant after adjusting for age and results of prerace physical inspection. CONCLUSIONS AND CLINICAL RELEVANCE: In Kentucky, injured horses had significantly less cumulative high-speed exercise than did control horses during the 1- and 2-month periods prior to the race in which injury occurred. These results differ from those observed in California. The association of injury with cumulative high-speed exercise appears to vary among regions in the United States.     

Risk factors for injury to the superficial digital flexor tendon and suspensory apparatus in Thoroughbred racehorses in New Zealand

AIM: To investigate risk factors for injury to the superficial digital flexor tendon (SDFT) and suspensory apparatus (SA) of the forelimbs in Thoroughbred racehorses in New Zealand. METHODS: Poisson and negative binomial regression, with exposure time represented by cumulative training days for each horse, were used to relate explanatory variables to the incidence rate (IR) of cases of inflammation of the SDFT (n=51), and injuries involving the SA (n=48) in a population of 1,571 commercially- trained racehorses over 554,745 study days. Only the first occurrence of an injury for any one horse was eligible for inclusion. Separate analyses were run for data from horses in training regardless of whether they had started in a trial or race, and using a subset of these data restricted to those preparations associated with at least one start in a trial or race. Results were reported as incidence rate ratios (IRR) and 95% confidence intervals (CI). RESULTS: Male horses had a higher risk of injury to the SA (IRR 2.57; p=0.005) and tended to have a higher risk of injury to the SDFT (IRR 1.74; p=0.09) than female horses. Increasing age was associated with increased risk of injury. Horses aged 4 and > or =5 years were 6.76 (p<0.001) and 15.26 (p<0.001) times more likely to incur injury to the SDFT, and 2.91 (p=0.02) and 3.54 (p=0.005) times more likely to incur injury to the SA, respectively, than 2-year-olds. Horses were more likely to suffer an injury to the SDFT or SA in a training preparation that was not associated with any starts in official trials or races compared with those preparations that were associated with more than one start (p<0.001), and more likely to injure the SA compared with preparations containing one start (p=0.03). The IR of injury to the SDFT tended to be lower between November-January (IRR 0.78; p=0.08) and February-April (IRR 0.75; p=0.08) compared with August-October. Incidence of injury to the SDFT or SA was not associated with the cumulative distance raced in the last 30 days of a training preparation. CONCLUSION: This study identified risk factors for injury to the SDFT and SA in Thoroughbred racehorses in New Zealand. Injuries were more likely in males, older horses and in horses in training preparations without any starts. There was no evidence of association between injury and cumulative high-speed exercise.